In this renewal of his mid-career investigator award in patient oriented-research, the candidate, Dr. Seward Rutkove, proposes to develop his mentoring efforts with young investigators in neurological research while continuing the pursuit of his long-term career goal of improving neuromuscular diagnostic techniques. Dr. Rutkove plans to mentor two specific groups of individuals, as he has been doing devotedly since his first K24 was funded in 2008. The first group of individuals consists of junior neurology faculty members, most of who work outside of Dr. Rutkove's subspecialty of neuromuscular disease. For these individuals, he will continue to hold regular, one-on-one meetings and will continue to organize a faculty seminar series to help share and generate research ideas. In addition, he will expand a 3X/year grant review and discussion meeting in which investigators, both junior and more senior, can examine individual researcher's specific aims and research ideas in an open forum. The second group of mentees generally consists of residents and fellows whose long- term goal is to become a successful patient-oriented researcher in neuromuscular disease, but who have not yet identified a specific area of research. For these individuals, Dr. Rutkove will take a more hands-on approach with regular one-on-one meetings and detailed guidance in identifying potential areas of research. It is also this group of individuals who will benefit most directly from Dr. Rutkove's proposed K-24-supported research in quantitative diagnostic ultrasound techniques for the evaluation of neuromuscular disease, since this area offers broad opportunities for new research directions and opportunities. Specifically, Dr. Rutkove's proposed research plan focuses on the development of a variety of innovative ultrasound-based tools for the assessment of muscle, including automated signal decomposition of the backscattered radiofrequency data, computer-assisted image segmentation, and volumetric, electrographic, anisotropic, and entropy-based analyses. These techniques will be applied to a broad group of adult subjects with neuromuscular disease, providing ample opportunity for mentees to both participate directly in patient-oriented research and to identify areas of research interest of ther own. The environment supporting this work is rich and includes the resources at the Department of Neurology at Harvard Medical School/Beth Israel Deaconess Medical Center, where Dr. Rutkove is based. In addition to these mentoring and research activities, during the funding period, Dr. Rutkove also plans on writing and publishing a guide for researchers interested in establishing a career in patient-oriented research, through Springer publishing. At the conclusion of the research period, Dr. Rutkove expects to have advanced the area of clinical neuromuscular disease research while helping launch the successful careers of a new set of clinical investigators.